Table 1Summary features of included studies

SettingStudy periodStudy DesignQI strategies employed*Outcomes reported
(duration)(Number of Patients)
2 endocrinology clinics (Canada)1 ---RCTSelf-Mx, Facil RelayDz: HbA1c, other
(3 months)(42)
2 clinics,---CBASelf-Mx, Facil relay, Org changeDz: HbA1c, other
(unspecified US city)2 (6 months)(117)
2 clinics---CBASelf-Mx, Facil relay, Org changeDz: HbA1c, other
(unspecified US city)2 (6 months)(87)
2 large clinics---RCTPatient Ed, Facil relay, Org changeDz: other
(Jacksonville, FL)3 (1 year)(138)Adhere: other
2 clinics, Baystate Medical Center1995-1996Quasi-RCTPrvdr EdDz: HbA1c
(Springfield, MA)4 (15 months)(144, 2 firms)
6 group practices---CBAPt Remind, Prvdr Ed, Facil relay, Org changeDz: HbA1c
(United Kingdom)5 (2 years)(242, 6 practices)
Individual GP offices and a public hospital outpatient clinic1994CBAFacil relay, Org changeDz: HbA1c
(Netherlands)6 (1 year)(275, 32 providers)
Massachusetts General Hospital Diabetes Center---RCTFacil relayDz: HbA1c
(Boston, MA)7 (1 year)(201)
Medical U. of South Carolina Adult Primary Care Center2001RCTPatient Ed, Org changeAdhere: other
(Charleston, SC)8 (6 months)(120)
Diabetes outpatient clinic1998-1999RCTOrg changeDz: HbA1c
(Australia)9 (1 year)(73)
Medicaid program---RCTFinancialPat comp
(Hennepin County, MN)10 (1 year)(96)
Diabetes foot clinic1995-1997CBAPatient Ed, Org changeDz: other
(Lithuania)11 (2 years)(145)
28 general practices1989-1995CBAPatient Ed, Self-Mx, Facil relay, Org changeDz: HbA1c, BP, other
(Netherlands)12 (6 years)(505, 28 providers)
6 primary care centers---CBAPrvdr Ed, Org changeAdhere: HTN/CAD, Foot/Eye, other
(Florida)13 (2 years)(1029, 6 practices)
24 non-training general practices1993RCTPrvdr Ed, Audit & FdbckAdhere: HbA1c, HTN/CAD, Foot/Eye, other
(United Kingdom)14 (1 year)(24 practices)
Diabetes centers1992-1993RCTPatient Ed, Self-Mx, Org changeDz: HbA1c
(Minnesota, Florida, Colorado)15 (6 months)(247)
124 general practices (The Netherlands)16 1996-1999RCTPrvdr Ed, Audit & FdbckAdhere: HTN/CAD, Foot/Eye, other
(3 years)(1431, 124 practices)
Diabetes clinic (Denmark)17, 18 1993-2001RCTPatient Ed, Org changeDz: HbA1c, BP, other
(9 years)(160)
University-affiliated family practice clinic---RCTPatient Ed, Prvdr EdDz: HbA1c
(unspecified US city)19 (6 months)(67)
2 primary care clinics---RCTPatient Ed, Self-Mx, Org changeDz: HbA1c, other
(unspecified US city)20 (3 months)(200)
Specialized diabetic service---RCTPatient Ed, Facil relay, Org changeDz: HbA1c, BP, other
(Netherlands)21 (1 year)(246, 15 practices)
10 primary care practices1993CBAPrvdr Ed, Audit & FdbckAdhere: HbA1c, HTN/CAD, Foot/Eye, other
(Germany)22 (8 months)(403, 17 providers)Pat comp
Hospital diabetic clinic and GP offices---RCTPrvdr Ed, Org changeDz: HbA1c
(United Kingdom)23 (5 years)(200)
29 general practices---RCTPrvdr Remind, Audit & FdbckDz: HbA1c, BP
(Norway)24 (21 months)(1034, 17 practices)Adhere: HbA1c, HTN/CAD, other
U. of Washington Family Medical Center1998-1999RCTPrvdr Ed, Audit & Fdbck, Org changeDz: HbA1c, BP
(Seattle, WA)25 (14 months)(109, 2 firms)
Royal Prince Alfred Hospital Diabetes Clinic---RCTOrg changeDz: HbA1c, BP, other
(Australia)26 (1 year)(137)Adhere: HbA1c, HTN/CAD, other
Pat comp
Royal Prince Alfred Hospital Diabetes Clinic---RCTSelf-Mx, Pt Remind, Prvdr Remind, Org changeDz: HbA1c, BP, other
(Australia)26 (1 year)(134)Adhere: HbA1c, HTN/CAD, other
Pat comp
General practices1988-1990RCTPt Remind, Facil relayDz: HbA1c, other
(Great Britain)27 (31 months)(181)
University-affiliated outpatient clinic---RCTPatient Ed, Org changeDz: HbA1c, other
(unspecified US city)28 (4 months)(45)
Ambulatory Care Quality Improvement Project1996-1998RCTAudit & FdbckAdhere: HbA1c, Foot/Eye
(Alabama)29 (25 months)(1931, 70 providers)
Cedars Sinai Medical Center1994-1995RCTPatient Ed, Prvdr EdDz: HbA1c, BP, other
(Los Angeles, CA)30 (1 year)(360, 43 practice teams)
5 outpatient practices in a university-based training program31 1998-1999RCTAudit & FdbckAdhere: other
(1 year)(497, 44 providers)
2 clinics---CBAPt Remind, Prvdr Ed, Org changeDz: HbA1c, other
(unspecified California city)32 (1 year)(2 practices)
14 independent physician offices---CBAPt Remind, Prvdr Ed, Org changeDz: HbA1c, other
(unspecified California city)32 (1 year)(2 practices)
Diabetes education program1998-1999RCTPatient Ed, Self-Mx, Pt Remind, Prvdr Remind, Facil relayDz: HbA1c, BP, other
(unspecified US city)33 (6 months)(150)
Choa Chu Kang polyclinic2000-2001CBAPatient Ed, Prvdr Remind, Org changeDz: HbA1c, BP
(Singapore)34 (7 months)(211)
Academic general medicine practice, Regenstrief Health Center1989-1991RCTPatient Ed, Pt Remind, Prvdr Ed, Prvdr RemindDz: other, Pat comp
(Indianapolis, Indiana)35 (2 years)(396, 4 firms)
Duke Family Medicine Center1993-1994RCTPrvdr RemindAdhere: HbA1c, HTN/CAD, Foot/Eye, other
(North Carolina)36 (6 months)(58 providers)
General medicine clinic, Indiana University Medical Center37 1978-1982RCTPrvdr Ed, Prvdr Remind, Audit & FdbckDz: HbA1c, BP, other
(3 years)(260, 13 firms)
General medicine clinic, Indiana University Medical Center37 1978-1982RCTPatient Ed, Pt Remind, Prvdr Ed, Prvdr Remind, Audit & FdbckDz: HbA1c, BP, other
(3 years)(273, 14 firms)
21 primary healthcare sites1999-2000RCTPt Remind, Prvdr Ed, Prvdr Remind, Audit & Fdbck, Org changeDz: other
(Australia)38 (13 months)(727, 21 practices)Adhere: HbA1c, HTN/CAD, Foot/Eye, other
Hospital-based Adult Medicine Clinic1998-1999RCTPrvdr Ed, Prvdr RemindDz: HbA1c, BP, other
(unspecified US city)39 (1 year)(598, 2 firms)Adhere: HbA1c, HTN/CAD, Foot/Eye, other
2 clinics1993-1995CBAPatient Ed, Audit & Fdbck, Org changeDz: HbA1c, other
(unspecified Midwest US city)40 (21 months)(267, 2 practices)
Endocrinology dept. tertiary care hospital2000-2001RCTPatient Ed, Facil relayDz: HbA1c, other
(South Korea)41 (3 months)(50)
311 general practices1989-1995RCTPatient Ed, Prvdr Ed, Prvdr Remind, Audit & FdbckDz: other
(Denmark)42 (6 years)(1263, 484 providers)
2 primary health-care centers1993-1994CBAOrg changeAdhere: HbA1c, HTN/CAD, Foot/Eye, other
(Sweden)43 (1 year)(408, 2 practices)Pat Comp
16 teaching-hospital affiliated primary care practices---CBAAudit & Fdbck, Org changeAdhere: other
(Boston, Massachusetts)44 (30 months)(16 practices)
2 general medicine clinics---RCTPatient Ed, Self-Mx, Facil relay, Org changeDz: HbA1c, other
(unspecified US city)45 (1 year)(148)Pat comp
4 university-affiliated VA clinics---RCTPatient Ed, Self-Mx, Pt Remind, Facil relay, Org changeDz: HbA1c, other
(unspecified US city)46 (1 year)(292)
Diabetes clinic, Vrije Universiteit Medical Center1997-1999RCTOrg changeDz: HbA1c
(The Netherlands)47 (20 months)(400)
9 primary health centers---CBAPatient Ed, Prvdr Ed, Facil relay, Org changeDz: BP, other
(United Arab Emirates)48 (18 months)(219, 9 practices)
General practices1992-1997CBAPrvdr Ed, Facil relay, Audit & FdbckDz: other
(The Netherlands)49 (5 years)(478, 27 providers)Adhere: HbA1c, HTN/CAD, other
3 Turku area podiatry clinics---RCTPatient Ed, Org changeDz: other
(Finland)50 (1 year)(530)Pat comp
Pleasanton facility, Kaiser Permanente Medical Care Program1995-1997RCTPatient Ed, Pt Remind, Org changeDz: HbA1c
(N. California)51 (6 months)(185)Pat comp
Sub-specialty diabetes clinic1996CBAOrg changeDz: HbA1c, BP
(unspecified US city)52 (3 months)(82)Adhere: HbA1c, Foot/Eye, other
Division of Community Internal Medicine, Mayo Clinic2000-2001RCTOrg changeDz: HbA1c, other
(Minnesota)53 (6 months)(727, 29 providers)Adhere: HbA1c, other
Division of Community Internal Medicine, Mayo Clinic2000-2001RCTPt Remind, Org changeDz: HbA1c, other
(Minnesota)53 (6 months)(752, 29 providers)Adhere: HbA1c, other
Diabetes clinic---RCTPatient Ed, Facil relay, Org changeDz: HbA1c
(Canada)54 (6 months)(46)
General practices---CBAOrg changeDz: other
(England)55 (16 months)(218)Adhere: HbA1c
35 primary care practices---RCTPatient Ed, Self-Mx, Org changeDz: HbA1c, other
(Seattle, Washington)56 (1 year)(707, 35 practices)Adhere: Foot/Eye, other
2 community health centers---RCTPrvdr EdAdhere: HbA1c, Foot/Eye, other
(unspecified Northeast US city)57 (1 year)(400, 2 practices)
2 community health centers---RCTPatient Ed, Prvdr EdAdhere: HbA1c, Foot/Eye, other
(unspecified Northeast US city)57 (1 year)(400, 2 practices)
Australia58 ---RCTPrvdr Ed, Audit & FdbckAdhere: HbA1c, HTN/CAD, Foot/Eye, other
(6 months)(265, 160 providers)
Australia58 ---RCTPrvdr Ed, Audit & FdbckAdhere: HbA1c, HTN/CAD, Foot/Eye, other
(6 months)(256, 160 providers)
General medical clinic, Durham Dept of VA Medical Center---RCTPatient Ed, Self-Mx, Pt Remind, Facil relay, Org changeDz: HbA1c, other
(North Carolina)59 (1 year)(275)
*

Pt Remind - patient reminder, Prvdr Remind - provider reminder, Org change - organizational change, Self-Mx — self-management, Facil Relay — facilitated relay of clinical data to providers, Patient Ed — patient education, Prvdr Ed — provider education, Audit & Fdbck — audit and feedback to provider Financial — financial or regulatory intervention

Dz: measure of disease control; hemoglobin A1c (HbA1c), blood pressure (BP); other.Adhere: measure of provideradherence to guideline or recommendation for measurement of HbA1c (labeled simply HbA1c), management of hypertension or coronary artery disease (HTN/CAD); screening or referral for detection of complications involving the foot or eye (foot/eye); other: patient education/counseling measurement of other lab value Pat comp: patient compliance

From: 2, Methods

Cover of Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 2: Diabetes Care)
Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 2: Diabetes Care).
Technical Reviews, No. 9.2.
Shojania KG, Ranji SR, Shaw LK, et al.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.